Individual
MR. ROBERT CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2565 TRADE WIND LN, #32, BOZEMAN, MT 59718-4634
(406) 529-4787
Mailing address
2565 TRADE WIND LN, #32, BOZEMAN, MT 59718-4634
(406) 529-4787
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-LAT-LIC-1156
MT
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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